#medicaid

I want to start off by acknowledging how fortunate I am. On top of being in a good place financially, I also have top notch insurance.

But I’d like to tell you a story about how that doesn’t make one shit of a difference in today’s America.

I have a chronic illness (rheumatoid arthritis), and coupled with the asthma I’ve had since childhood, this pair makes getting a cold or the flu a combination of pretty fucking terrible and terrifying. There are times when I’m sick that I worry at any given moment I suddenly won’t be able to breathe. Everywhere I’ve ever lived, the first thing I do is map out hospitals that take my insurance in case I have to rush there for emergency breathing treatments. Sometimes I wake up at 3am with a heavy, congested chest and wonder if I need to wake up my boyfriend to drive me to the emergency room.

Because of these issues, I applied for a nebulizer from my insurance company. A nebulizer is a heavy-duty air compressing unit for asthmatics that delivers an intense dose of medication. From the age of 7 to 24, I used one of these units. I used it so much that I wore out the motor. Getting this nebulizer cut my emergency room visits in half. It was a godsend for my family.

When I was diagnosed with RA, I applied for another unit. I was getting sick all the time due to my compromised immune system, and I wanted to have a nebulizer on hand in case an issue with my asthma arose. Since the age of 28, I’ve applied for a nebulizer 4 times. I have not once been able to get it approved.

Last year, I tried one more time. Why not?! I had brand new insurance! And happily, I managed to get the medicine that goes inside the nebulizer approved! A box of 150 doses of albuterol shipped to my house the same day I got a notice that the nebulizer had NOT been approved.

What. The. Ever. Loving. Fuck.

Why? I have a history of asthma. I have autoimmune. I have 150 vials of albuterol sitting on my front fucking porch! Why?!

The explanation I received was that it wasn’t deemed critical because I could receive a nebulizer treatment at a nearby EMERGENCY ROOM. An emergency room nebulizer treatment would cost me upwards of $300; an at-home nebulizer treatment would cost me 10¢.

Today, I’m sitting here with in the midst of a terrible flu, having finally broken through a 100° fever, and I found myself wondering if I should go to the emergency room for a nebulizer treatment because I’m having trouble breathing. And then, in a desperate daze, I find myself cleaning out my old essential oil diffuser and filling it with liquid albuterol doses and saline solution and sitting in the mist it’s spewing out while I do deep meditation breaths and try to inhale this weird patch of medication provided by a discount Amazon product because the insurance I PAY FOR won’t approve a life-saving machine I need.

This is part of why I care about socialized medicine more than anything else. The number one cause of bankruptcy in America is a bad medical diagnosis. But like I said, I’m fortunate. Unfortunately diagnosed, but fortunate. In a state of frustration and anger, I spent the rest of evening searching for a nebulizer, which I just paid for out of pocket - no problem. But that’s me.

But sure, tell me more about how we need tax cuts for the rich.

i spent three hours on the phone today (attempting to) make medical appointments

in particular i am having trouble finding a therapist. my medicaid HMO farms out its mental health services to ANOTHER sketchy “behavioral health” HMO. i called them and asked for mental health clinics not too far from my neighborhood that take my particular insurance. 

she cheerfully gave me three referrals with three different phone numbers. all three phone numbers were incorrect – either i got a recorded answer saying “this is no longer the number for this service, please call this other number” or the number was disconnected entirely. i ended up googling the names of the clinics she listed, and after trying about five different numbers, eventually i found the correct phone number for all three clinics. 

(it is worth noting here that this is far from the first time that having computer skills has supplemented my navigation of the welfare system. having internet access and literacy is something that many, many people in this system do not have. thus, even though most of the time i feel like a broke down bitch, i also recognize how lucky i am in many, many ways.)

the first clinic no longer takes my insurance, even though my insurance company says it does. the second clinic has recently restructured, and is “unsure” if they take my insurance, and said they’d get back to me. at the third, i only got a voice mailbox – however, it is at a hospital that i happen to know recently went bankrupt and may close basically any day now. 

however, i still feel fortunate, and hopeful: to have insurance, to have access to health care, to have a gp that will manage my mental health meds on a casual basis until i can find a “real” psychiatrist (and let’s face it, most medicaid psychiatrists are like, 15-appointment, revolving-door medicine types) and hopefully (whoa boy i hope) a decent therapist. 

PS i have NO IDEA if any of these places are “trans–friendly.” i am pretty much just jumping in feet first. i’m faaairly good at advocating for myself in the mental health system and generally therapists like me (i “display a high degree of insight into my problems” ie i have the language skills of someone who went to college for a while), and so unless something goes terribly wrong, i’m generally able to be nbd about mental health providers who are like ???? about trans stuff. 

that said, i have had some experiences with being trans in the mental health system that range from merely facepalm-y to truly frightening, which i will blog about more some time later. 

chibimonkey:

I got out of a very abusive, controlling relationship a few years ago with very little money to my name and moved back in with my parents. I’ve been saving to get an apartment, which is about $1100-1300/month here, ever since. I got a job that allowed me to save up, but I was also relentlessly harassed, bullied, overworked, and sexually assaulted to the point where I had a series of mental breakdowns that ultimately led me to quit.

I lost my new boyfriend a few years later due to my father’s interference. My father doesn’t want me here. Before I moved home he actually hadn’t spoken to me in three years, because my previous boyfriend was black. He says I deserve all the abuse “that n*gger” put me through, which included complete alienation of all my friends, complete control and exploitation of my finances, brief homelessness, and the death of my child. He tried to throw me out a month into dating my new boyfriend because “he can put you up now.” Between my job and my father, I was always stressed and miserable, and my boyfriend couldn’t take it. Then he got cancer, and told me he couldn’t deal with my problems on top of his own, he couldn’t take my father anymore, and we couldn’t do this anymore. We broke up. All his friends, even the ones who were supposedly my friend too, sided with him.

I lost a tooth at the beginning of the pandemic, right in the front of my face. It was a crown that had broken. I can’t afford to fix it - I need an extraction of the remaining tooth and an implant, which is $6k total. I only have Medicaid, which the oral surgeon doesn’t take and which doesn’t cover implants anyway. My self esteem tanked.

I don’t have any friends. I’m autistic and have never been great at making them in the first place, and wasn’t able to repair the friendships I lost because of my ex. I don’t talk to my extended family, who my father has been telling for years that I’m an ungrateful, horrible bitch he wishes he never had. They agree with him. Talking to my mother is like talking to a brick wall. She’s so burnt out putting up with my father’s abuse that she can’t even pretend to be a support for me. She never has been anyway.

Most of the time I feel like a glitch in a computer program. I’m not supposed to be here, so people ignore me until I cause problems (whether I actually did or not). No one cared when I was being abused by my ex, even when I came to work crying every day and couldn’t afford to eat. No one said anything in my defense when I was being harassed at work, and after I was assaulted HR told me it was all in my head when I’d report things like “Joe and Brian are telling people they fucked me in the stock room.” Sometimes I’ll vent on social media - both where I know people and where I’m anonymous - and get no response, except maybe “stop saying xyz about people, be grateful for what you have.” I had to delete Facebook because it added to my depression.

I can’t hold a job anymore. I’m terrified of people and being outside. I recently got a freelance gig doing transcription but the pay is very low and only per minute of audio, and I suffer from migraines which makes it difficult. I’ve posted on social media that I can also do editing and proofreading, with no takers. My health has always been very poor and my mental health is trash. No therapist near me takes Medicaid and I’m afraid to go out and talk to one anyway. I’ve been denied state assistance, though I was recently approved for food stamps. I can’t get cash assistance. I’m burning through all of my savings with student loans (which apparently can’t be put on hold because they’re all private) and the rent my dad demands.

On top of all this, my mother just told me she’s divorcing my dad, because he’s abusive and cheats constantly. She’s disabled and won’t be able to keep the house so she’s moving out. She’s the only reason I’ve been able to stay here. I’m pretty sure my father will kick me out, or tell me I can only stay if I become the maid and yard caretaker. He’s already trying to sell my car (which he had to put in his name because my ex destroyed my credit), which will leave me trapped in the house, and my mother has made it clear I can’t move in with her.

My cousins all have their lives figured out. They’re all married with kids, as I’m constantly being reminded of, with their own houses or apartments and good jobs. They’re not afraid of people, or struggling with money, or having a panic attack at 1am on a Wednesday because they don’t know how they’re going to get through the next week, let alone the next year. It feels like the cat is the only one on my side and the only one who actually wants anything to do with me. Ten years ago my father called me a failure as a daughter, an adult, and a human being, and it’s just… true.

I got out of a very abusive, controlling relationship a few years ago with very little money to my name and moved back in with my parents. I’ve been saving to get an apartment, which is about $1100-1300/month here, ever since. I got a job that allowed me to save up, but I was also relentlessly harassed, bullied, overworked, and sexually assaulted to the point where I had a series of mental breakdowns that ultimately led me to quit.

I lost my new boyfriend a few years later due to my father’s interference. My father doesn’t want me here. Before I moved home he actually hadn’t spoken to me in three years, because my previous boyfriend was black. He says I deserve all the abuse “that n*gger” put me through, which included complete alienation of all my friends, complete control and exploitation of my finances, brief homelessness, and the death of my child. He tried to throw me out a month into dating my new boyfriend because “he can put you up now.” Between my job and my father, I was always stressed and miserable, and my boyfriend couldn’t take it. Then he got cancer, and told me he couldn’t deal with my problems on top of his own, he couldn’t take my father anymore, and we couldn’t do this anymore. We broke up. All his friends, even the ones who were supposedly my friend too, sided with him.

I lost a tooth at the beginning of the pandemic, right in the front of my face. It was a crown that had broken. I can’t afford to fix it - I need an extraction of the remaining tooth and an implant, which is $6k total. I only have Medicaid, which the oral surgeon doesn’t take and which doesn’t cover implants anyway. My self esteem tanked.

I don’t have any friends. I’m autistic and have never been great at making them in the first place, and wasn’t able to repair the friendships I lost because of my ex. I don’t talk to my extended family, who my father has been telling for years that I’m an ungrateful, horrible bitch he wishes he never had. They agree with him. Talking to my mother is like talking to a brick wall. She’s so burnt out putting up with my father’s abuse that she can’t even pretend to be a support for me. She never has been anyway.

Most of the time I feel like a glitch in a computer program. I’m not supposed to be here, so people ignore me until I cause problems (whether I actually did or not). No one cared when I was being abused by my ex, even when I came to work crying every day and couldn’t afford to eat. No one said anything in my defense when I was being harassed at work, and after I was assaulted HR told me it was all in my head when I’d report things like “Joe and Brian are telling people they fucked me in the stock room.” Sometimes I’ll vent on social media - both where I know people and where I’m anonymous - and get no response, except maybe “stop saying xyz about people, be grateful for what you have.” I had to delete Facebook because it added to my depression.

I can’t hold a job anymore. I’m terrified of people and being outside. I recently got a freelance gig doing transcription but the pay is very low and only per minute of audio, and I suffer from migraines which makes it difficult. I’ve posted on social media that I can also do editing and proofreading, with no takers. My health has always been very poor and my mental health is trash. No therapist near me takes Medicaid and I’m afraid to go out and talk to one anyway. I’ve been denied state assistance, though I was recently approved for food stamps. I can’t get cash assistance. I’m burning through all of my savings with student loans (which apparently can’t be put on hold because they’re all private) and the rent my dad demands.

On top of all this, my mother just told me she’s divorcing my dad, because he’s abusive and cheats constantly. She’s disabled and won’t be able to keep the house so she’s moving out. She’s the only reason I’ve been able to stay here. I’m pretty sure my father will kick me out, or tell me I can only stay if I become the maid and yard caretaker. He’s already trying to sell my car (which he had to put in his name because my ex destroyed my credit), which will leave me trapped in the house, and my mother has made it clear I can’t move in with her.

My cousins all have their lives figured out. They’re all married with kids, as I’m constantly being reminded of, with their own houses or apartments and good jobs. They’re not afraid of people, or struggling with money, or having a panic attack at 1am on a Wednesday because they don’t know how they’re going to get through the next week, let alone the next year. It feels like the cat is the only one on my side and the only one who actually wants anything to do with me. Ten years ago my father called me a failure as a daughter, an adult, and a human being, and it’s just… true.

#IAmAPreExistingCondition: Medicaid is the Lifeline that Saved Me

I owe my health and ability to live in this disabled body to Medicaid.  It is the social program that is will be under attack if the Senate accumulates enough votes for the American Health Care Act (AHCA).  The AHCA is the replacement bill for the Affordable Care Act (ACA), better known as Obamacare.  There are provisions within the AHCA that will impact those of us with pre-existing conditions…

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Ok y'all, so I’ve been working remote for a call center for a medicaid dental company for almost 2 months now. And it’s honestly better than retail, but there are still some definite pros and cons.

Pros:

• Working from home fucking rules.
• I was in training for over a month, 2 weeks in an actual training class, 3 weeks in a nesting period (basically you’re taking calls, getting comfortable with taking calls, but you’re still technically in training so there’s like this safety net) and I feel like I actually got properly trained before transitioning to operations.
• This company is awesome. They genuinely want you to succeed, and they even promote from within. Like seriously. 2 out of the 3 team leads when I was in nesting got promoted in the 3 total weeks I was in nesting, and even another coworker and I got offered higher positions a week into training.
• My coworkers and even my supervisors are great. In my training class I was with the best group of people I’ve ever worked with. We all got kind of split up when we all moved to operations and I genuinely miss them.
• I also feel like I’m genuinely helping people.
• It’s full time, and I get health, dental, and vision insurance.

Cons

• The people. OH MY GOD THE PEOPLE. It’s the same dumbass people I’ve had to deal with in retail, but now they’re not breathing down my neck, which is honestly better.
• “Can you help me find an eye doctor?” Ma'am we are a medicaid DENTAL insurance company. (I understand that they may have one card for their entire medicaid plan, but this happens too often)
• Trying to find a dentist that will take medicaid is absolutely infuriating sometimes. Especially in rural areas and…Florida??? For some reason???
• Like seriously I had someone from Florida was trying to find a dentist for their 3 year old who had tooth pain, and it was damn near impossible. And it wasn’t like they were in a small town or rural area, they were in like, Orlando.
• Another time I had someone from Idaho call trying to find a prosthodontist (dentist who specializes in dentures) and the only one I could find, was over 100 miles away from their zip code, wasn’t accepting new patients, and didn’t even accept medicaid for people over 18. And this was the only one I could find within a 250 mile radius, which is as far as my portal will let me search.
• When assigning a dentist to a member, I can’t just assign them to a dental group. No, I have to assign them to an individual facility, as well as an individual dentist. Makes sense, cause some facilities within the dental group might take our insurance. Some others may not, and I just can’t assign them to any dentist in that facility, cause what if that dentist is completely booked out for the next 6 months? Or what if they’re retiring tomorrow? Or what if it’s a specialist that’s only there once a month? But this is especially frustrating when the people calling don’t remember the name of the dentist. And most of them will ask if they can call and see, but then there’s the ones that are just like “Oh I didn’t make an appointment yet, can’t you just assign me any dentist?” Or the one lady who got snippy and said “ Well I gave YOU the number, can’t YOU call and check?” As if it’s my fucking responsibility to know which dentist you made the appointment with.
• There is one thing I hate more than anything else in this job, and it is filing disenrollment requests. I can understand why people want to dis-enroll. Maybe the dentist that they’re seeing no longer accepts our specific insurance and they really want to stay with that provider, or they’re having a problem trying to find any dentist that will take this insurance. That’s understandable. I don’t have a problem with that. I have a problem with the entire process in general. Because it’s not like some box I can check that says “Member would like to dis-enroll” No, I have to file a grievance, and then get approval from my supervisor before I can submit it, and then this person, who just wants to go to the dentist, has to wait for us to send in a letter (which there’s no time frame for how long that could take, so if the person has a dental emergency and can’t find any dentists that will take their insurance, they’re just fucked I guess) telling them whether or not the request was approved or denied, because yes, a disenrollment request can be denied, for WHATEVER REASON. And it takes FOREVER. If it’s just one person it’s not so bad, but yesterday I had to dis-enroll a mother and her SEVEN CHILDREN. I was on that call for OVER AN HOUR. Not to mention our messaging system was down so I had to get approval by emailing my supervisor, which takes longer and is harder because I can’t send confidential medical info through email. That’s a HIPAA violation.
• Our breaks and lunches are scheduled, and it’s fucking bonkers. Why on earth is my lunch break at 3:15, when I start at 9AM??? Why is my last break scheduled half an hour before I leave for the day? And why do I have to fill out an adherence tracker form whenever I’m late for my breaks? I was on a call??? My supervisors are able to see that???

Looking for an oral surgeon

Me: So I found an oral surgeon but it’s about 39 miles away is that OK?

Lady on the phone: Oh no, that’s too far.

Me: I understand ma'am but that’s the next closest one that’s not ‘Oral Surgeon You Said Was Completely Booked Out.’ What I can do is I can find you a General Dentist, because they can also do things like pull teeth, and we can go from there.

Lady on the phone: Well I went to 'Undisclosed General Dentist’ and they told me I need to see an oral surgeon.

Me: Ma'am I understand, but this is the NEXT CLOSEST oral surgeon I can find.

Lady on the phone: Well are there any in 'City I Live In?’

Me:

Despite popular belief, repeatedly telling me that you need to find an oral surgeon will not magically make more oral surgeons appear. I’m sorry I can’t find anything closer, I know this is something that you need to get done, and I understand that you’re probably in a lot of pain. But you need to understand that there is only SO MUCH I CAN DO. I am not medicaid. I do not determine which facilities will take medicaid. I do not determine the number of oral surgeons in your area. I am just the bottom of the barrel, lowest on the pecking order fucking call center employee trying to help you stumble through this fucked up system as best as I can, and getting mad at ME isn’t going to make ANY of this easier.

What the fuck does ot take to get a root canal in Florida on Medicaid? I just got off the phone with someone looking for an Endodontist and every single one I could find was over 100 miles away. And it wasn’t like they were in a rural area either, they were right near Miami and Ft. Lauderdale.

So I just took a call. It was a mother calling about her daughter, she needed to have teeth extracted, and they had already scheduled an appointment elsewhere, and she was supposed to be going in for surgery tomorrow, but they just called the mom and told her they’re no longer taking her daughter’s insurance. Apparently they found out a week ago. Why they didn’t tell her a week ago, both me and the mom don’t understand. Thank fucking god I was able to find a different facility that did take her insurance, and I was able schedule an appointment for her to be seen tomorrow, but FUCK.

Her daughter is in pain. The mom was literally crying on the phone with me, just completely furious, and I don’t blame her at all. This is fucking despicable, that the fucking dental facilities care more about getting paid than actually taking care of people. This isn’t the first call I’ve had like this. It happens too often. This shouldn’t happen at all.

Honestly this job makes me want to eat the rich even more because getting even just a basic dental exam and cleaning shouldn’t be this fucking hard, whether you’re on medicaid or not.

Dear Congress,

Thanks for reminding my husband that even though he’s an "American hero" he and military families are expendable. 

Thanks for waging a war and sinking our money into a country that has been at war for centuries.  Wait, that’s not even paid for yet….thanks China.

Oh, but even if we do get paid for doing our job you’re going to screw over the poor people most of which are too sick to work.  Yes its their fault for being “lazy” with cancer, hip replacements, or PTSD from one of your past wars.

And you’re going to punish ½ of South Carolina’s kids, the ½ that are on Medicaid because its their fault they grew up with “lazy” parents.

That sounds like something Jesus would do, crush the poor and abandon children.

And when we start getting paid again you get to tell me what’s best for my family and my options as a woman for health care. 

You preach “no government control” until it comes to my uterus or even the conversations I have with my doctor.

Thanks for reminding everyone that medical care is not a right, its a privilege in this society.  And destroying medical benefits under the guise of abortion.

Let’s distract everyone and complain about NPR and PBS! Those communist bastards are eating up one tenth of one percent of the budget.

You disgust me.